학술논문
Frequency and impact on renal transplant outcomes of urinary tract infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species
Document Type
article
Author
Jakob E. Brune; Michael Dickenmann; Daniel Sidler; Laura N. Walti; Déla Golshayan; Oriol Manuel; Fadi Haidar; Dionysios Neofytos; Aurelia Schnyder; Katia Boggian; Thomas F. Mueller; Thomas Schachtner; Nina Khanna; Stefan Schaub; Caroline Wehmeier; the Swiss Transplant Cohort Study; Patrizia Amico; John-David Aubert; Adrian Bachofner; Vanessa Banz; Sonja Beckmann; Guido Beldi; Christoph Berger; Ekaterine Berishvili; Annalisa Berzigotti; Pierre-Yves Bochud; Sanda Branca; Heiner Bucher; Anne Cairoli; Emmanuelle Catana; Yves Chalandon; Sabina De Geest; Sophie De Seigneux; Joëlle Lynn Dreifuss; Michel Duchosal; Thomas Fehr; Sylvie Ferrari-Lacraz; Jaromil Frossard; Christian Garzoni; Nicolas Goossens; Jörg Halter; Dominik Heim; Christoph Hess; Sven Hillinger; Hans Hirsch; Patricia Hirt; Linard Hoessly; Günther Hofbauer; Uyen Huynh-Do; Franz Immer; Michael Koller; Andreas Kremer; Christian Kuhn; Bettina Laesser; Frédéric Lamoth; Roger Lehmann; Alexander Leichtle; Hans-Peter Marti; Michele Martinelli; Valérie McLin; Katell Mellac; Aurélia Merçay; Karin Mettler; Nicolas Müller; Ulrike Müller-Arndt; Beat Müllhaupt; Mirjam Nägeli; Graziano Oldani; Manuel Pascual; Jakob Passweg; Rosemarie Pazeller; Klara Posfay-Barbe; David Reineke; Juliane Rick; Anne Rosselet; Simona Rossi; Rössler; Silvia Rothlin; Frank Ruschitzka; Alexandra Scherrer; Dominik Schneidawind; Macé Schuurmans; Simon Schwab; Thierry Sengstag; Federico Simonetta; Jürg Steiger; Guido Stirniman; Ueli Stürzinger; Christian Van Delden; Jean-Pierre Venetz; Jean Villard; Julien Vionnet; Madeleine Wick; Markus Wilhlem; Patrick Yerly
Source
Frontiers in Medicine, Vol 11 (2024)
Subject
Language
English
ISSN
2296-858X
Abstract
BackgroundEnterobacterales are often responsible for urinary tract infection (UTI) in kidney transplant recipients. Among these, Escherichia coli or Klebsiella species producing extended-spectrum beta-lactamase (ESBL) are emerging. However, there are only scarce data on frequency and impact of ESBL-UTI on transplant outcomes.MethodsWe investigated frequency and impact of first-year UTI events with ESBL Escherichia coli and/or Klebsiella species in a prospective multicenter cohort consisting of 1,482 kidney transplants performed between 2012 and 2017, focusing only on 389 kidney transplants having at least one UTI with Escherichia coli and/or Klebsiella species. The cohort had a median follow-up of four years.ResultsIn total, 139/825 (17%) first-year UTI events in 69/389 (18%) transplant recipients were caused by ESBL-producing strains. Both UTI phenotypes and proportion among all UTI events over time were not different compared with UTI caused by non-ESBL-producing strains. However, hospitalizations in UTI with ESBL-producing strains were more often observed (39% versus 26%, p = 0.04). Transplant recipients with first-year UTI events with an ESBL-producing strain had more frequently recurrent UTI (33% versus 18%, p = 0.02) but there was no significant difference in one-year kidney function as well as longer-term graft and patient survival between patients with and without ESBL-UTI.ConclusionFirst-year UTI events with ESBL-producing Escherichia coli and/or Klebsiella species are associated with a higher need for hospitalization but do neither impact allograft function nor allograft and patient survival.